Compact counter balance for robotic surgical systems

ABSTRACT

In one embodiment of the invention, an apparatus is provided including a linkage and a balancing mechanism coupled to the linkage around a pivotal joint. The linkage couples to a support structure at a first end and support a weight applied to a second end. The balancing mechanism counter balances the weight applied to the second end of the linkage. As the linkage is deformed to vertically adjust the height of the weight with a different moment arm length, the balancing mechanism varies a cable path length to modify the compression of a spring and a tension in a cable to adjust the amount of counter balance force applied to the linkage.

CROSS-REFERENCE TO RELATED APPLICATIONS

This non-provisional United States (U.S.) patent application claims thebenefit of and is a continuation-in-part (CIP) of U.S. patentapplication Ser. No. 11/043,688 filed on Jan. 24, 2005 by inventorsThomas G. Cooper, et al., entitled “MODULAR MANIPULATOR SUPPORT FORROBOTIC SURGERY”, pending, which is incorporated herein by reference.

FIELD

The present invention is generally related to robotic surgical systems.More specifically, the embodiments of the invention are related tocounter balancing systems for robotic surgical arms.

BACKGROUND OF THE INVENTION

Previously, robotic surgical arms of robotic surgical systems weresupported over a patient by mounting the robotic surgical arms to apatient's table or by mounting them to a patient side cart that waswheeled over the floor to the patient.

A patient side cart takes up floor space and typically requires cablesrouted along the floor between a master console and the patient sidecart. The cords are easy to trip upon. Moreover, the patient side cartand the robotic surgical system require a set-up procedure. Sometimesinstead to being at a patient's side, the patient side cart ispositioned at the head or feet of the patient. After the surgery iscompleted, the patient side cart is moved out of the way. A patient sidecart is heavy and difficult to move.

Additionally, while off the floor, mounting the robotic surgical arms toa patient's table typically limits the range of motion and the types ofsurgeries that may be performed. Robotic surgical arms may be mounted toeither or both sides of the patient's table. However when mounted to thetable, the robotic surgical arms are often limited in range of motion toavoid bumping one another.

It is desirable to mount the robotic surgical arms over a patientwithout cluttering the operating room floor while maintaining asignificant range of motion in robotic surgical arms.

BRIEF SUMMARY OF THE INVENTION

The embodiments of the invention are summarized by the claims thatfollow below.

BRIEF DESCRIPTION OF THE DRAWINGS

The following drawings should be read with reference to the detaileddescription. Like numbers in different drawings refer to like elements.The drawings, which are not necessarily to scale, illustratively depictembodiments of the present invention and are not intended to limit thescope of the invention.

FIG. 1 is a perspective view of a robotic surgical system, including amaster surgeon console or workstation for inputting a surgical procedureand a ceiling mounted robotic cart, including positioning linkages whichallow a plurality of patient side robotic manipulators for roboticallymoving surgical instruments having surgical end effectors at surgicalsites, one endoscope camera robotic manipulator, and a monitor to bepre-configured.

FIGS. 2A through 2H illustrate perspective and top views of the set-upjoint arm supporting and positioning a robotic patient side manipulatoror robotic surgical arm.

FIG. 3 is a right side perspective view of a first set-up arm with acompact counter balance mechanism. FIG. 4 is a left side perspectiveview of the first set-up arm with the compact counter balance mechanism.

FIG. 5 is a right side cutaway view of the first set-up arm with thecompact counter balance mechanism.

FIGS. 6A-6B are right side magnified cutaway views of the compactcounter balance mechanism in an angular position and a horizontalposition.

FIG. 7 is a right side cutaway view of second set-up arm with a compactcounter balance mechanism.

FIG. 8 is a perspective view of the compact counter balance link.

FIG. 9 is a perspective view of the compact counter balance link withthe hollow housing removed.

FIG. 10 is a magnified cutaway view of a portion of the compact counterbalance link.

FIGS. 11A-11B are perspective views of the compact counter balance linkwith removed elements.

FIGS. 12A-12B are exploded perspective views of the clamping mechanism.

FIG. 13 is a side perspective view of a cable end tensioning mechanism.

FIG. 14A is a diagram of a spring counter balancing mechanism for alink.

FIG. 14B is a schematic diagram of the spring counter balancingmechanism of FIG. 14A.

FIG. 15A is a diagram of a spring, pulley, and cable counter balancingmechanism for a link.

FIGS. 15B-15C are schematic diagrams of the spring, pulley, and cablecounter balancing mechanism of FIG. 15A.

FIGS. 16A-16C are views of the end plug that is inserted into the cavityto provide additional stiffness to the counter balancing link.

FIGS. 17A-17B are perspective views of an assembled ribbonizer andclamping block illustrated in exploded views of FIGS. 12A-12B.

DETAILED DESCRIPTION OF THE INVENTION

In the following detailed description of the embodiments of theinvention, numerous specific details are set forth in order to provide athorough understanding of the present invention. However, it will beobvious to one skilled in the art that the embodiments of the inventionmay be practiced without these specific details. In other instances wellknown methods, procedures, components, and elements have not beendescribed in detail so as not to unnecessarily obscure aspects of theembodiments of the invention.

In one embodiment of the invention, a set-up arm is provided to supporta robotic arm. The set-up arm includes a first set-up joint to couple toa support structure, a second set-up joint to couple to a robotic arm toprovide support thereto; an idle link pivotally coupled between thefirst set-up joint and the second set-up joint, a counter balancing linkcoupled between the first set-up joint and the second set-up joint, athird pulley coupled to the counter balancing link between the counterbalancing link and the first set-up joint, and at least one cable undertension wrapped over the first, second, and third pulleys, and coupledto the set up arm. The center points of the first pulley, the secondpulley, and the third pulley form a triangle. The first set-up joint hasa bracket with the first pulley rotatably coupled thereto. The counterbalancing link generates a counter-balancing force to balance out aforce of the weight or load at the second set-up joint. The counterbalancing link includes a hollow housing having a cylindrical cavitywith a first diagonally cut end forming an oval opening to increasestiffness. The counter balancing link further includes the second pulleyrotatably coupled to the housing, the post coupled to the housing, and afirst compression spring in the cylindrical cavity of the housing withits first end coupled to the housing. The first compression spring isunder compression to balance out the force of weight at the secondset-up joint. The at least one cable under tension is coupled to asecond end of the first compression spring near its end.

In another embodiment of the invention, a method for a set-up arm of arobotic surgical system is provided. The method includes balancing alinkage structure with a spring-cable-pulley balancing mechanism tosupport a weight or load; moving the linkage structure to vary themoment of a weight at a pivot point when the weight is at the end of alink; and changing a path length of one or more cables over a pluralityof pulleys in the spring-cable-pulley balancing mechanism to compress ordecompress a spring to increase or decrease tension in the one or morecables to balance the variance in the moment.

In yet another embodiment of the invention, a counter-balanced arm isprovided including a first link, a second link pivotally coupled to thefirst link at a first pivot point, a third pulley rotatably coupledbetween the second link and the first link at the first pivot point, anda cable coupled to the second link, routed over the third pulley, thefirst pulley, and the second pulley. The first link can couple to asupport mechanism at a first end. The first link has the first pulleyrotatably coupled thereto. The second link has the second pulleyrotatably coupled thereto. The second link further has a firstcompression spring having a first end coupled thereto. The cable isfurther coupled to a second end of the first compression spring to forma tension in the cable to counter balance a weight applied at an end ofthe second link.

In still another embodiment of the invention, an apparatus is providedincluding a linkage and a spring-cable-pulley balancing mechanismcoupled to the linkage around a pivotal joint. The linkage couples to asupport structure at a first end and support a weight at a second end.The spring-cable-pulley balancing mechanism counter balances the weightat the second end of the linkage. As the linkage is deformed tovertically adjust the height of the weight with a different moment armlength, the spring-cable-pulley balancing mechanism varies a cable pathlength to modify the compression of a spring and a tension in a cable toadjust the amount of counter balance force applied to the linkage.

Ceiling Mounted Robotic Surgical System

Referring now to FIG. 1, a robotic surgical system 100 is illustratedincluding a perspective view of an exemplary modular manipulator supportassembly 130, a platform linkage 192, and a surgeon's console 103. Theplatform linkage 192 may couple to a ceiling 101 or overhead supportstructure by means of a pair of brackets 124. The modular manipulatorsupport assembly 130 is slidingly coupled to the platform linkage 192.

An operator O (generally a surgeon) performs a minimally invasivesurgical procedure on a patient lying on an operating table T under themodular manipulator support assembly 130 and the platform linkage 192.The operator O manipulates one or more input devices or masters 102 atthe surgeon's console 103. In response to the surgeon's inputs, acomputer processor 113 of console 103 directs movement of endoscopicsurgical instruments or tools 105, effecting servo-mechanical movementof the instruments via the modular manipulator support assembly 130. Theimage of the internal surgical site is shown to surgeon or operator O bya stereoscopic display viewer 112 in the surgeon's console 103, and issimultaneously shown to assistant A by an assistant's display 104.Assistant A assists in pre-positioning the manipulators 132, 134relative to patient P using set-up linkage arms 138, 140, 142, 144; inswapping tools 105 of the one or more of surgical manipulators foralternative surgical tools or instruments; and in operating relatednon-robotic medical instruments and equipment, and the like.

The modular manipulator support assembly 130 aligns and supports roboticmanipulators, such as patient side manipulators 132 or endoscope cameramanipulator 134, with a set of desired surgical incision sites in apatient's body. The modular manipulator support assembly 130 generallyincludes an orienting platform 136 and a plurality of configurableset-up joint arms 138, 140, 142, 144 coupleable to the orientingplatform 136. Each arm 138, 140, 142, 144 is movably supporting anassociated manipulator 132, 134 which in turn movably supports anassociated instrument. It will be appreciated that the depictions arefor illustrative purposes only and do not necessarily reflect the actualshape, size, or dimensions of the modular manipulator support assembly130. This applies to all depictions described hereinafter.

In general terms, the arms or linkages 138, 140, 142, 144 comprise apositioning linkage or set-up arm portion of system 100, typicallyremaining in a fixed configuration while tissue is manipulated, and themanipulators 132, 134 comprise a driven portion which is activelyarticulated under the direction of surgeon's console 103. Themanipulators 132,134 are primarily used for master/slave tissuemanipulation, while the set-up arms 138, 140, 142, 144 are used forpositioning and/or configuring the manipulators 132, 134 before use,when repositioning the patient, operating table, incision points, andthe like.

For convenience in terminology, manipulators 132 actuating tissue withsurgical tools 195 is sometimes referred to as a PSM (patient sidemanipulator), and a manipulator such as 134 controlling an image captureor data acquisition device, such as endoscope 111, is sometimes referredto as an ECM (endoscope-camera manipulator), it being noted that suchtelesurgical robotic manipulators may optionally actuate, maneuver andcontrol a wide variety of instruments, tools and devices useful insurgery.

The orienting platform 136 generally supports a plurality of set-upjoint arms SJA1 140, SJA2 142, and SJX 144 for movably supporting theassociated patient side manipulators 132. Typically, each armaccommodates translation of the patient side manipulator in threedimensions (x, y, z) and rotation of the patient side manipulator aboutone vertical axis (azimuth). Generally, the set up joint arms 140, 142,and 144 support robotic surgical arms or patient side manipulators(PSM). Either or both of the right and left surgeon controls 102 mayflexibly drive the robotic surgical arms or patient side manipulatorscoupled to the set-up joint arms 140, 142, and 144. The surgeon O mayselect and switch between which arm he is controlling with the mastercontrols 102 such as by using a foot pedal.

The orienting platform 136 further supports one set-up joint center arm138 (SJC) for movably supporting the endoscope camera manipulator 134.It will be appreciated that the set-up arms 138, 140, 142, 144 mayinterchangeably support and position instrument 132 or camera 134manipulators. Utilization of the orienting platform 136 to support theindividually positionable set-up arms 138, 140, 142, 144 and associatedmanipulators 132, 134 advantageously results in a simplified singlesupport unit having a relatively scaled down, compact size. For example,the single orienting platform 136 may obviate any need to individuallyarrange and mount each set-up arm 138, 140, 142, 144 to a mounting base,which is often confusing and cumbersome. This in turn allows for afaster and easier set-up.

The orienting platform 136 may further include a display 104. Thedisplay 104 may be used for set-up purposes, instrument changes, and/orfor personnel viewing of a procedure. The display 104 is preferablyadjustably mounted to the orienting platform 136 with a parallelogramlinkage 106 so that personnel can view the monitor in a desireddirection. The platform linkage 192 movably supports the orientingplatform 136 at a fifth hub 190. That is, the fifth hub 190 iscoupleable to the platform linkage 192. The fifth hub 190 may be alignedwith the pivot point of the set-up joint center arm 138, which ispreferably coincident with its incision site for the endoscope. Thefifth hub 190 provides for rotation of the orienting platform 136 abouta vertical axis as denoted by arrow SJC1 in FIG. 1. Rotation of theorienting platform 136 about the pivot point of the endoscopemanipulator 134 which is aligned with the surgical incisionadvantageously allows for increased maneuverability of the orientingplatform 136 and associated set-up arms 138, 140, 142, 144 in thedirection in which a surgical procedure is to take place. This is ofparticular benefit during complex surgeries, as manipulator 132, 134positioning may be varied mid-operation by simply rotating the orientingplatform 136 about the fifth hub 190. Typically, the instruments will beretracted prior to rotation for safety purposes. For small rotations ofthe orienting platform 136 or tilting of the operating table, the lowfriction and balanced arms 140, 142, 144 may float while attached to thecannula during movement, pushed by force from the incisions.

Rotation of the orienting platform 136 about hub 190 (SJC 1), rotationof the set-up joint arms 140, 142 about hubs (SJA1 1), and rotation ofthe set-up joint auxiliary arm 144 about a hub are preferably poweroperated, but may alternatively be manual or computer controlled. Motorsdriving belt and pulley mechanisms for orienting platform rotation (SJC1) are within the orienting platform 136. A brake system may also beincluded to allow the orienting platform 136 to be locked into place.Motors driving belt and pulley mechanisms for right, left, and auxiliaryset-up arm rotation (SJA11, SJX1) 140, 142, 144 respectively may also becontained within the orienting platform 136.

The platform linkage 192 generally comprises a linear rail 108, aslideable carriage 110 coupleable to the rail 108, and at least one arm112 rotationally coupleable to the carriage 110 on a proximal end 114and to the orienting platform 136 via hub 190 on a distal end 116. Theplatform linkage 192 advantageously enhances maneuverability of themodular manipulator support 130 by accommodating translation of theorienting platform 136 in three dimensions (x, y, z). Movement of theorienting platform in a generally horizontal direction is denoted byarrow OP1. Movement of the orienting platform in a generally verticaldirection is denoted by arrow OP2. Movement of the orienting platform inand out of the page is articulated by rotational movement of joint 120,as denoted by arrow OP3. The platform linkage 192 further accommodatesrotation of the orienting platform 136 about one vertical axis, asdenoted by arrow SJC 1. The arm 112 preferably comprises a four barparallelogram linkage 118 extending between a pair of adjacent joints120, 122. It will be appreciated that although the fifth hub 190accommodates rotation of the orienting platform 136 (SJC1), the systemmay also be designed wherein the fifth hub 190 is rotationallycoupleable to the platform linkage 192 so that the platform linkageaccommodates pivotal motion of the orienting platform.

The orienting platform's 136 enhanced range of motion due to theplatform linkage 192 permits access to incision sites over a wide rangeof the patient's body. This of particular benefit when performingcomplicated and lengthy procedures, where the manipulators 132, 134 maybe quickly repositioned mid-operation to alternative surgical sites.Typically, the instruments will be retracted prior to translation orrotation of the orienting platform 136 for safety purposes. The platformlinkage 192 is preferably power operated, but may alternatively bemanual or computer controlled. Motors may be located within the platformlinkage 192 or orienting platform 136 to drive pulley and beltmechanisms. A brake system may also be included to allow the platformlinkage 192 to be locked into place.

The platform linkage 192 may be mounted to a mounting base (not shown)via bolts and brackets 124 or other conventional fastener devices. Themounting base preferably comprises a ceiling-height support structurethat may be coupled to the ceiling 101 so as to permit the manipulatorsupport assembly 192, 130 to extend generally downward from the base. Aceiling-height mounted manipulator support assembly 192,130advantageously improves space utilization in an operating room,particularly clearing up space adjacent the operating table forpersonnel and/or other surgical equipment as well as minimizing roboticequipment and cabling on the floor. Further, a ceiling-height mountedmanipulator support assembly minimizes the potential for collisions orspace conflicts with other adjacent manipulators during a procedure andprovides for convenient storage when the robotic surgery system is notin use.

The term “ceiling-height support structure” includes support structuresdisposed on, adjacent, or within an operating room ceiling and includessupport structures disposed substantially below an actual ceilingheight, especially in the case of a higher-than-typical operating roomceiling. The mounting base permits the manipulator support assembly 192,130 to be stored by pulling it against the wall. The mounting base mayinclude existing architectural elements, such as original or reinforcedstructural elements, joists, or beams. Further, the mounting base may beformed from sufficiently rigid and stiff materials to inhibit vibration.Alternatively, passive means such as viscous or elastomer dampers oractive means such as servomechanisms may be used to counteract vibrationor interfloor movement of the hospital building in vertical and/orhorizontal directions.

Set-Up Joint Arms and Robotic Surgical Arms

Each set-up joint arm 138, 140, 142, 144 has simplified kinematics dueto the improved range of motion provided by the manipulators 132, 134.Typically, the arms accommodate translation of the fixable links andjoints in a generally vertical direction such as denoted by arrow SJC3for arm 138 in FIG. 1 and arrow SJA13 for arm 140 in FIGS. 2E,2G. Thearms also accommodate rotation of the fixable links and joints about twoor three vertical axes.

Referring now to FIGS. 2A-2H, an exemplary set-up joint arm 140 andpatient side manipulator 132 are illustrated. Set-up joint arm 140 isexemplary of each of the other set-up joint arms 138, 142, 144. Patientside manipulator 132 is exemplary of the endoscopic camera manipulator140. Top views of the set-up joint arm 140 supporting the patient siderobotic manipulator 132 are shown by FIGS. 2A-2B. The set-up joint arm140 has four degrees of freedom (SJA11, SJA12, SJA13, SJA14), whereinthe SJA11 joint is motorized and the other joints are manuallypositioned. FIGS. 2C and 2D illustrate rotational motion of the set-upjoint arm 140 as denoted by arrow SJA12. FIGS. 2E and 2F illustrate bothtranslational and rotational motion of the set-up joint arm 140 asdenoted by arrows SJA13, and SJA14. The translational and rotationalaxes for the left set-up joint arm 142 (SJA2) is substantially similarto that of the right set-up joint arm 140 (SJA1).

As seen in FIG. 2A, arrows SJA11, SJA12, and SJA14 illustrate therotational joints 260, 248, 250 respectively of the set-up joint arm140. The translational and rotational axes for the left set-up joint arm142 (SJA2) are substantially similar to that of the right set-up joinarm 140 (SJA1).

The set up joint arms 138, 140, 142, 144 may be power operated, computercontrolled, manually pre-configured, or a combination thereof.Preferably, joint SJA11 of the set-up joint arm 140 is motorized whilethe other joints are manually positioned. Motors may be located withinthe plurality of fixable links or orienting platform to drive pulley andbelt mechanisms.

The fixable joints of the set-up arms 138, 140, 142, 144 typicallyinclude a brake system to allow the joints to be locked into place afterthe arms are appropriately deployed. In FIG. 2A, the brake systemreleasably inhibits articulation of the fixable links 252, 258, andjoints 248, 250, previously configured in at least substantially fixedconfiguration. The brake system is preferably biased toward the fixedconfiguration and includes a brake release actuator for releasing thefixable links 252, 258 and joints 248, 250 to a repositionableconfiguration in which the fixable links and joints can be articulated.The system may further include a joint sensor system coupling aplurality of the fixable links 252, 258 and joints 248, 250 to aservomechanism. The sensor system generates joint configuration signals.The servomechanism includes a computer and the joint sensor systemtransmits the joint configuration signals to the computer. The computercalculates a coordinate system transformation between a referencecoordinate system affixed relative to a mounting base and theinstruments using the joint configuration signals.

Referring now to FIG. 1 and FIG. 2A, the manipulators 132, 134 aremechanically constrained so that a manipulator base 266 is at a fixedangle relative to horizontal. The manipulator 132 supported by theset-up joint arm 140 is angularly offset relative to horizontal in arange from forty degrees to about sixty degrees, preferably from aboutforty-five degrees to about fifty degrees. The manipulator 132 supportedby the set-up joint auxiliary arm 144 is angularly offset relative tohorizontal in a range from zero degrees to about twenty degrees,preferably by about fifteen degrees. The manipulator 134 supported bythe set-up joint center arm 138 is angularly offset relative tohorizontal in a range from forty degrees to about ninety degrees,preferably from about sixty-five degrees to about seventy degrees.

Preferably, the manipulators 132, 134 comprise offset remote centerlinkages for constraining spherical pivoting of the instrument aboutpivot points 278 in space, wherein actuation of the fixable links andjoints of the set-up joint arms 138, 140, 142, 144 moves the pivotpoints. As discussed above, the overall complexity of the roboticsurgical system may be reduced due to the improved range of motion ofthe system. Specifically, the number of degrees of freedom in the set-upjoints arms 138, 140, 142, 144 may be reduced (e.g., less than sixdegrees of freedom). This allows for a simpler system platform requiringless pre-configuration of the set-up joint arms 138, 140, 142, 144. Assuch, operating room personnel may rapidly arrange and prepare therobotic system for surgery with little or no specialized training.

Exemplary manipulators 132, 134 providing for reduced mechanicalcomplexity of the set-up arms 138, 140, 142, 144 are described infurther detail in U.S. patent application Ser. No. 10/957,077, which isincorporated herein by reference.

In FIG. 2A, the offset remote center manipulator 132 generally includesthe manipulator base 266, a parallelogram linkage base 268, a pluralityof driven links and joints 270, 272, and an instrument holder 274. Themanipulator base 266 is rotationally coupled to the parallelogramlinkage base 268 for rotation about a first axis, also known as the yawaxis. The parallelogram linkage base 268 is coupled to the instrumentholder 274 by rigid links 270, 272 coupled together by rotational pivotjoints. The driven links and joints 270, 272 define a parallelogram soas to constrain an elongate shaft of the instrument or cannula 276relative to a center of rotation (also referred to as a pivot point) 278when the instrument is mounted to the instrument holder 274 and theshaft is moved along an insertion axis. The first axis and a first sideof the parallelogram adjacent the parallelogram linkage base 268intersect the shaft at the center of rotation 278, wherein the firstside of parallelogram is angularly offset from the first axis.

The manipulator base 266 of the surgical manipulators 132, 134 ismounted and supported at a constant elevation angle by set-up arms 138,140, 142, 144. The manipulator base 266 in this embodiment is fixed to amanipulator base support 280 of the set-up arms 138, 140, 142, 144 byscrews or bolts. Although the exemplary set-up arms 138, 140, 142, 144have a manipulator base support 280 suited to the geometry of a remotecenter manipulator 132, 134, manipulator base support 280 may take on avariety of alternative support configurations to suit other telesurgicalmanipulators. For example, the manipulator base support may beconfigured to support further alternative remote center manipulators,natural center manipulators, computed center manipulators, softwarecenter manipulators, and manipulators employing a combination of thesefunctional principles. Further, as noted above, the manipulator basesupport 280 of the set-up arms 138, 140, 142, 144 may interchangeablysupport and position instrument 132 or camera 134 manipulators.

In operation, once the motorized joint position SJA11 is set, typicallyto preset values, the user has only to align each remote center of thepatient side manipulator with each incision. This may be done byattaching each patient side manipulator to the associated cannula whichis already positioned within the incision. This automatically sets theset-up joint positions, as there is no remaining redundancy. The lowfriction and balancing of these three joints allows the patient sidemanipulators to float so that each manipulator can be controlled byholding it advantageously at a single point. Setting a motorized jointto a different position will result in a different azimuth angle for thepatient side manipulator after the cannula is attached. In other words,the function of the redundant, motorized joint is to allow the patientside manipulator manipulator to be farther from or closer to anotherpatient side manipulator or endoscope manipulator. Alternatively, afterthe cannula is attached, the azimuth can be adjusted by operating themotor while the set-up joint brakes are released and the cannula is heldat the incision.

Compact Counter Balancing Mechanism

Each of the set-up joint arms 138, 140 142, 144 defines releasablyfixable links and joints that are pre-configurable. Each set-up jointarm 138, 140, 142, 144 includes at least one balanced, fixable, jointedparallelogram linkage structure 246 extending between a pair of adjacentfixable rotational joints 248, 250. The set-up joint arms 138, 140, 142,144 may be balanced by a variety of mechanisms including weights,tension springs, gas springs, torsion springs, compression springs, airor hydraulic cylinders, torque motors, or combinations thereof. In apreferred embodiment of the invention, a compact counter balancingmechanism is provided to balance the weight of the set-up joint arms anda robotic surgical arm, such as the patient side manipulators 132 andendoscopic camera manipulator 134. Changes in tools or instruments 105at the end of patient side manipulators 132 typically has no effect onthe counter balancing mechanism as the weight of the tool or instrumentsis usually insignificant.

As shown in FIG. 2A, the set-up joint arm 140 includes the balanced,fixable, jointed parallelogram linkage structure 246 extending between apair of adjacent fixable rotational joints 248, 250. The jointedparallelogram linkage structure 246 accommodates motion in a generallyvertical direction, and the adjacent rotational joints 248, 250accommodate pivotal motion about vertical axes SJA12, SJA14. One or morelinear or curved sliding axes could be used in lieu of any or all of therotary ones. Each of the parallelogram linkage structures in the set-upjoint arms may have a generally similar structure to the parallelogramlinkage structure 246, in this example comprising a parallel link 252(including an upper link or idle link 291 and a horizontal or counterbalancing link 292), a proximal bracket 254, and a distal bracket 256.The proximal bracket 254, and the distal bracket 256 may also bereferred to as proximal and distal ends respectively of the parallellink 252.

The parallel link 252 is pivotally jointed to proximal and distalbrackets 254, 256 respectively in a vertically-oriented planarparallelogram configuration. This permits pivotal motion of the parallellink 252 in the vertical plane, while constraining the brackets 254, 256to remain substantially parallel to one another as the parallelogramlinkage structure 246 deforms or changes shape. As discussed previously,the rotational set-up joints 248, 250 and their respective brackets254,256 accommodate pivotal motion about the vertical axes SJA12, SJA14,respectively. Thus, the parallel link 252 and the bracket 254 may pivotin a horizontal plane about the set-up joint 248 and its axis SJA12.

As illustrated by FIGS. 2C-2D, the parallel link 252 includes the upperlink or idle link 291 and the horizontal link or counter balancing link292 pivotally coupled between and to the brackets 254,256. The idle link291, the counter balancing link 292, and the brackets 254,256 form theparallelogram linkage structure 246. The bracket 256, rotational joint250, and the manipulator 132 can move vertically with respect to thebracket 254 and rotational joint 248 as illustrated by arrows SJA13 inFIGS. 2E and 2G.

FIG. 3 illustrates a right side magnified perspective view of theparallelogram linkage structure 246 including the idle link 291, thecounter balancing link 292, the proximal bracket 254, and the distalbracket 256. As shown in FIG. 3, the idle link 291 is pivotally coupledto the proximal bracket 254 at a pivotal joint 301 and to the distalbracket 256 at a pivotal joint 302. The counter balancing link 292 ispivotally coupled to the proximal bracket 254 at a pivotal joint 311 andto the distal bracket 256 at a pivotal joint 312. The pivotal joints301,311,302,312 are located at the corners of the parallelogram linkagestructure 246.

FIG. 4 illustrates a left side magnified perspective view of theparallelogram linkage structure 246 of the set up joint arm 140. In oneembodiment of the invention, the set-up joint arm 140 couples to aceiling height support structure through the joint 260.

At joint 301 between the bracket 254 and the idle link 291, the set upjoint arm 140 includes a potentiometer 401 to measure the position ofthe parallelogram linkage structure 246. At joint 311 between thebracket 254 and the counter balancing link 292, the set up joint arm 140includes a set-up joint brake 411. When engaged, the set-up joint brake411 at the joint 311 can hold the position of the parallelogram linkagestructure 246.

FIG. 5 illustrates a cutaway view of the parallelogram linkage structure246 including the idle link 291, the counter balancing link 292, theproximal bracket 254, and the distal bracket 256. The counter balancinglink 292 includes a substantial portion of the spring-cable-pulleybalancing mechanism 500 that generally operates around the pivotal joint311.

The spring-cable-pulley balancing mechanism 500 includes one or morecables 501 coupled to the set-up arm that are wrapped over a pluralityof pulleys 502-504 and tensioned by a compressible spring assembly 602.The one or more cables 501 may couple to the set-up arm by coupling tothe set-up joints or the counter balancing link 292. In one embodimentof the invention, the one or more cables 501 may have segments that wrapover the plurality of pulleys 502-504 in one direction, wrap around apin or post 505 to couple to the counter balancing link, and then routeback and wrap over the pulleys 502-504 in a reverse direction. Wrappingthe one or more cables around the pin or post 505 in this manner is aconvenient way to have segments of a single cable act like a redundantpair of cables. Alternatively one end of each of the one or more cablesmay be clamped to the pin or post 505 or coupled to the set-up arm, thecounter balancing link 292, or one or the set-up joints by some othercoupling mechanism. At least one end of each of the one or more cables501 is clamped to an end of a compression spring 515 of the compressiblespring assembly 602.

In one embodiment of the invention, the compression spring 515 is a coilspring. A compression spring is considered safer than a tension springfor a number of embodiments of the invention. If a tension springbreaks, the ends may fly apart and it would then be unable to provideany load to balance out any weight. On the other hand, if a compressioncoil spring breaks, the coil at the broken point will move slightly torest on the next coil in the spring. This slight movement may onlychange the load by a small amount (e.g., 5-10%), which may be computedby multiplying the space between coils by the spring rate.

In one embodiment of the invention, there are four cables 501 undertension that wrap over post 505 making a U-turn so that eight cablesegments are coupled to the end of the spring 515. In one embodiment ofthe invention, there is a total tension of approximatelyfour-hundred-eighty pounds for all of the eight cable segments such thateach substantially shares sixty pounds of tension.

In one embodiment of the invention, the plurality of pulleys 502-504 areof equal diameter. Each of the pulleys 502-504 and the post 505 mayinclude one or more tracks in which the one or more cables 501 arewrapped and guided to substantially maintain their alignment. Pulley 504is concentric with the pivotal joint 311 coupling to a shaft at thepivotal joint. With the one or more cables 501 wrapped over it, thepulley 504 does not rotate relative to the counter balancing link 292.However, the counter balancing link 292 and the pulley 504 rotatetogether about the pivotal joint 311 with respect to the bracket 254.Pulley 503 is rotationally coupled to an adjustable mount 513 that iscoupled to the bracket 254. The adjustable mount 513 may slide in thebracket 254 to adjust the position of pulley 503 and further adjust thetension in the cable 501 and spring 515 during set-up and maintenance.Changing the length of one of the sides of the triangle (sides a or b inthe theory described below), adjusts the counter-balancing mechanism forvariations in spring rate or the amount of weight being balanced.However, the adjustable mount 513 is rigidly fixed in placed duringoperational periods so that the position of the pulley 503 rotatablycoupled to the adjustable mount 513 does not change. Pulley 502 isrotationally coupled to the housing of the link 292 and thus pivots withthe link about the pivotal joint 311. The center points or center pointpositions of the pulleys 502-504 are the corners or vertices of atriangle.

Referring now to FIGS. 6A-6B, magnified cutaway views of the counterbalancing link 292 and the counter balancing mechanism 500 in differingpositions are illustrated. The link 292 includes a hollow housing 601with a cylindrical cavity 611 to receive the compressible springassembly 602. In one embodiment of the invention, the cylindrical cavity611 is a circular cylindrical cavity. Including the compressible springassembly 602 in the link 292 makes for a more compact counter balancingmechanism. The housing 601 of the link 292 has a slanted or diagonallycut end 603 to allow for movement against the bracket 256 and the joint250 while maintaining the strength of the link. The slanted end 603 alsoprovides an oval opening into the cavity 611 through which the springassembly 602 may be assembled. The housing 601 of the link 292 also hasan opposite slanted or diagonally cut end 604 to allow for movementagainst the bracket 254 and the joint 248 while maintaining the strengthof the link.

In some applications, such as medical or robotic surgical systems, it isdesirable to make the parallelogram linkage structure stiff so that asubstantially solid supporting structure may be provided. This is usefulin preventing undesired vibrations that may be excited by movement, suchas from movements in the robotic arm. Referring momentarily to FIG. 5,the pivotal joints 301,311 at one end and the pivotal joints 302,312 atan opposite end are positioned so as to be widely spaced apart withrespect to the housing of the links 291,292. That is, the pivotal jointsof the idle link are located near the top outside portion of the linkand the pivotal joints of the counter balancing link are located nearthe bottom outside portion of the link. This lengthens the left andright sides of the parallelogram linkage structure respectively alongthe brackets 254,256. The stiffness of the sides of the parallelogramlinkage structure along the brackets is proportional to a square of thedistance of separation between the pivotal joints 301, 311 and thepivotal joints 302,312. A bottom side of the housing 601 of the link 292is made relatively strong to make it stiff and withstand the tension andcompression in the link 292 between the pivotal joints 311-312. Theupper link 291 provides additional stiffness and strength to withstandthe tension and compression in the parallel link 252 through thestructure of its housing between the pivotal joints 301-302.

Moreover, a tube may be torsionally stiffened if the ends are notallowed to deform but are maintained in shape, such as a circular shape.Referring back to FIGS. 6A-6B, a small opening 621 in the slanted ordiagonally cut end 604 of the housing 601 allows the one or more cables501 to be routed into the cylindrical cavity 611. To maximize stiffness,the small opening 621 in the slanted or diagonally cut end 604 throughwhich the cables are routed is made as small as possible. In the ovalopening at the opposite end 603 of the link 292, a plug 613 is insertedto maintain the cylindrical shape of the cavity 611. The plug has a slit813 (see FIG. 8) on one side. The slit 813 is forced apart by a screwafter installation to expand the plug against the wall or walls of thecavity 611. The plug 613 reduces the size of the oval opening to asmaller opening at the end of the link 292 to increase its torsionalstiffness. When the link 292 is finally assembled together, the ends ofthe cavity 611 are substantially closed with small openings in each tomaximize stiffness.

In some applications, the linkage need not be so stiff or support heavyloads such that a serial linkage structure may be employed instead of aparallelogram linkage structure. In which case, a first link may haveone end directly coupled to a ground or indirectly coupled to ground andan opposite end pivotally coupled to a second link, the counterbalancing link.

The spring assembly 602 includes the spring 515 and a cable clampingmechanism 615. The cable clamping mechanism may also be referred to as aspring piston. The spring 515 is mounted against a flange 614 of thehousing 601 at one end and coupled to the one or more cables 501 at anopposite end by the cable clamping mechanism 615. The cable clampingmechanism 615 may include a clamping sleeve 612 and one or more cableend tensioners 616. These and other elements of the cable clamingmechanism 615 are described further below with reference to FIGS. 8-13.

The pulleys 502-504 are in substantial alignment together in a planesuch that their center points or center point positions are corners of atriangle. The relative positions of pulleys 503 and 504 to each other donot change when the link 292 and the linkage structure moves, such asillustrated by FIGS. 6A-6B. The relative positions of pulleys 502,504and the post 505 to each other do not change when the link 292 moves.Thus, two sides of the triangle (the side between pulleys 503-504 andthe side between pulleys 504-505) formed by the pivot points of thepulleys 502-504 do not change in length. However, the positions of thepulley 502 and the post 505 do change with respect to pulley 503. Thus,the side of the triangle between pulleys 502 and 503 changes length asthe link 292 and linkage structure are moved. That is the triangleformed by the pivot points of the pulleys 502-504 is adjustable inresponse to movement of the counter balancing link 292. In a horizontalposition of the counter balance link and the parallelogram linkagestructure, such as illustrated in FIG. 6B, the adjustable triangleformed by the pivot points of the pulleys 502-504 may form a righttriangle with at least one corner angle between the sides substantiallybeing a ninety degree angle.

Consider for example, a linear distance X1 between pulleys 502 and 503when the link 292 is angled upward as illustrated in FIG. 6A. The lineardistance between the pulleys 502-503 increases to distance X2 when thelink 292 is horizontal, as illustrated in FIG. 6B. A wrap angle of thecable 501 around individual pulleys 502-504 may change as well. However,the sum total wrap angle around the pulleys may remain constant as endsof the cable don't change angle relative to each other. The wrap angleis the angle around the pulley to which the cable makes contact. Thewrap angle may also be viewed as the arctuate distance that a segment ofthe cable contacts the pulley. For example, the wrap angle of the cable501 making contact to the pulley 504 is a first angle θ₁ when the link292 is angled upward as illustrated in FIG. 6A. In FIG. 6B, the wrapangle of the cable 501 making contact to the pulley 504 decreases to asecond angle θ₂ when the link 292 is horizontal as illustrated in FIG.6B. Thus, as the post 505 moves with respect to the pulley 503 from itsposition in FIG. 6A to that of its position in FIG. 6B, some of thecable 501 may be paid out over the pulley 504 to compensate slightly forthe increase in the distance between pulleys 502 and 503. Moreover, thewrap angle of the cable 501 around pulley 502 increases from its initialposition in FIG. 6A to that of FIG. 6B, and the wrap around pulley 503increases also, so that the total wrap angle around all of the pulleys502-504 is conserved. As the total wrap angle around all of the pulleysremains the same, a cable path length PL changes by the same amount asthe difference between the linear distances X2 and Xl. That is, thechange in cable path length, delta(PL), can be determined by thefollowing equation:delta(PL)=X2−X1

A change in the cable path length around the pulleys results in a changein tension in the spring 515 and the one or more cables 501. For a givenweight at the joint 250, a greater moment at axis 311 is applied to thelink 292 when the link is in the horizontal position as illustrated inFIG. 6B than when the link 292 is in the upward angled position asillustrated in FIG. 6A. This is due to different moment arm lengths inthe different positions of the counter balancing link and the differentdeformations of the parallelogram linkage structure. Assuming the totalcable length remains constant (e.g., there is no stretch or slippage inthe clamps), as the distance X2 between the pulleys 502-503 becomesgreater than X1, the cable 501 is pulled on and out from the link 292 toadditionally compress the spring 515 and compensate for the greatermoment being applied at the axis 311. If the link 292 is moved furtherdownward (not shown) past the horizontal position that is illustrated inFIG. 6B, an additional length of cable is pulled out from the link 292to further compress the spring 515 and further increase the tensiontherein. As the link goes below horizontal, the triangle formed by thepulleys becomes obtuse and there is a loss in mechanical advantage forthe spring. The loss in mechanical advantage is compensated for by theincreased compression. As the link 292 moves back to its upward angledposition, such as illustrated in FIG. 6A, the cable 501 is released backinto the link 292 so that the spring 515 is decompressed and the tensionis reduced in the spring 515 and cable 501 to compensate for a lowerlevel of moment being applied at the axis 311. In this manner after theinitial tensions are set, the link 292 can properly counter balance aweight at differing positions with respect to the bracket 254 and thejoint 248.

FIGS. 5 and 6A-6B illustrate one embodiment of a counter balance link292 and idle link 291 in a set-up arm. However, the counter balance link292 and idle link 291 in the set-up arm may be further compacted tradingoff the amount of motion. For example, the counter balance link 292 maymove positive and negative forty degrees from the horizontal positionillustrated in FIG. 6B. If less motion is acceptable, the counterbalance link may be further compacted.

Referring now to FIG. 7, an embodiment of a more compact counter balancelink 292′ in a set-up arm is illustrated. An idle link 291′ is coupledin parallel to the counter balancing link 292′. The counter balance link292′ may move positive and negative thirty degrees from a horizontalposition, such as that illustrated by link 292 in FIG. 6B Referring nowto FIGS. 6A-6B and 7, the link 292′ is somewhat similar to link 292including similar elements with slight differences. For example, thelink 292′ includes pulleys 502′-504′ and post 505′ similar to pulleys502-504 and post 505 in link 292. However the positions of the pulleys502′,504′ and post 505′ differ somewhat from the position of pulleys502,504 and post 505. The one or more cables 501′ in the link 292′ areshorter than cables 501 in link 292 given the lesser degree of motion.The hollow housing 601′ of the link 292′ is shorter than the hollowhousing 601 of the link 292. An opening 621′ into the cylindrical cavity611′ of the housing 601′ differs somewhat from the opening 621 into thecylindrical cavity 611 of the housing 601. The spring 515′ in the link292′ is shorter than the spring 515 in the link 292. But for thesedifferences, the elements of link 292′ function similar to the elementsof link 292.

Referring now to FIG. 8, a perspective view of the compact counterbalance link 292 separate from the parallelogram linkage structure 246is illustrated. At the slanted or diagonally cut end 603 of the housing601, the plug 613 closes the cavity 611 in the housing 601. One or morecable end tensioners 616 extend out from the plug 613. Near the oppositeend of the housing is a shaft 802 extending through the housing withends coupled to thereto.

Referring now to FIG. 9, a perspective view of the compact counterbalance link 292 is illustrated with the hollow housing 601 removed tobetter show the internal elements. Within the housing 601, the pulley502 is rotatably coupled to the shaft 802. Within the housing 601 at thepivotal joint 311, the pulley 504 is mounted on a shaft 902 betweenspaced apart pair of bearings 820 mounted on the shaft. The shaft 902extends through the base of the housing 601 at one end. At the oppositeend of the base at the pivotal joint 312, another shaft 903 extendsthrough the base of the housing 601 and has another pair of spaced apartbearings 820 mounted thereto.

The plug 613 has a cylindrical shape to match the cavity and has a flatend at one end and a slanted oval-like shaped end at an opposite end tomatch the slanted or diagonally cut end 603 of the housing 601. Theclamping sleeve 612 of the cable clamping mechanism 615 may be coaxialwith the spring 515 in a center opening thereof so that it issubstantially surrounded by the spring 515.

Referring now to FIG. 10, a magnified cutaway view of a portion of thecompact counter balance link 292 is illustrated.

The cable clamping mechanism 615, also referred to as a spring piston,includes the clamping sleeve 612 (also referred to as a counterbalancetube); a mating ring 1002 (also referred to as a spring flange); athrust bearing 1004, a preload adjustment nut 1006, and an anti-rotationplate 1008 coupled together as shown.

Referring now to FIGS. 10 and 16A-16C, the plug 613, is inserted intothe cavity 611 to plug up the opening in one end of the housing 601. Thefastener 1031 is inserted into the threaded hole 1631 to maintain thealignment of the plug 613 in an appropriate position along the cavitywall. A spreading screw 1030 is inserted into a threaded opening 1630 inthe split side of the plug 613. A set screw 1632 may be inserted into athreaded opening 1631 to provide a backstop for the spreading screw1030. Alternatively, the threaded opening 1631 may be filled solidforming part of the split flange. As the end of the spreading screw 1030aligns and mates with the end of the set screw 1632, the split 813 andthe plug 613 begin to expand. With further tightening of the screw 1030,the split 813 expands further forcing the sides of plug tightly againstthe wall of the cavity 611 to torsionally stiffen the compact counterbalance link 292. If the plug 613 is to be removed, the set screw 1632may be removed and the spreading screw 1030 may be replaced with aspecial screw that has threads removed near its head, so that it canturn freely on the threads on that side of the split. If the sides ofthe plug 613 are stuck in expansion against the wall of the cavity, thespecial screw may be further threaded into the opening 1631 pulling thesplit side of the plug together and the sides of the plug away from thewall of the cavity. In this manner, the plug should be more readilyremoved from the cavity 611 for disassembly and maintenance of thecounter balance link.

The plug 613 has a center opening 1602 to allow the one or more cableend tensioners 616 to pass through to the clamping block 1012. The oneor more cable end tensioners 616 are used to remove slack andpre-tension the one or more cables 501 with substantially equal tensionduring assembly. The one or more cable end tensioners 616 are betterillustrated in FIG. 13.

Referring momentarily to FIG. 13, each of the one or more cable endtensioners 616 includes a pre-tensioning spring 1302 and a cableterminator 1303. The cable terminator 1303 may be a ball, a sphere, atube, a cylinder, or other block shape. The cable terminator 1303 has acylindrical opening 1313 to slide over the end of the cable 501. Thecable terminator 1303 may be crimped to an end to the cable 501 toretain the spring 1302 on the cable. The pre-tensioning spring 1302 istrapped between the clamping block 1012 of the clamping sleeve 612 onone side and the cable terminator 1303 on the opposite side. Thepre-tensioning springs 1302 pull out on the one or more cables 501 topretension the cables prior to clamping the clamping block 1012 thereto.

Referring now back to FIG. 10 and to FIGS. 12A-12B and FIGS. 17A-17B,the clamping mechanism 615 includes the threaded counter balance sleeve612,the clamping block 1012, the mating ring 1002, the thrust bearing1004, the ribbonizer 1015, the threaded nut 1006, and the alignmentplate 1008. The one or more cables 501 are routed through the spring515, the ring 1002, the bearing 1004, the threaded sleeve 612, theribbonizer 1015, and the nut 1006 into and through openings 1204 of theclamping block 1012 and an opening 1120 in the alignment plate 1008.

The ribbonizer 1015 is formed of two ribbonizer halves 1015A-1015B. Eachhalf 1015A-1015B has a planar portion 1202A-1202B, respectively, thatare spaced apart to planarize and substantially align the one or morecables 501 for routing over the pulley 502. When the halves are coupledtogether, the planar portions 1202A-1202B in each leave an opening 1202into the ribbonizer 1015. The two ribbonizer halves 1015A-1015B includea slot 1212A-1212B respectively to receive the clamping block 1012.During assembly, the two ribbonizer halves 1015A-1015B are inserted intoand fit tightly within the threaded sleeve 612. The ribbonizer halvesfurther include a ridge segment 1224A-1224B to mate with a circular edgeof the threaded sleeve 612, acting as a stop so that the ribbonizer doesnot move further down into the threaded sleeve. The clamping block 1012doesn't move relative to threaded sleeve 612 or the ribbonizer 1015.

The clamping block 1012 may be formed of five clamping plates1214A-1214B, 1215A-1215C stacked over each other together to clamp tothe one or more cables 501. The five clamping plates 1214A-1214B,1215A-1215C capture the one or more cables 501 in grooves 1204A-1204Bbetween each. Each of the interior clamping plates 1215A-1215C mayinclude a pair of grooves 1204A on one side and a pair of grooves 1204Bon the opposite side and a pair of holes 1221 to allow the clampingscrews 1028A-1208B to slide through. The outer clamping plate 1214A mayinclude the pair of grooves 1204B in a bottom side while the outerclamping plate 1214B includes the pair of grooves 1204A in a top side.The grooves 1204A-1204B are a little shallower than half the diameter ofa cable 501. In one embodiment of the invention, the diameter of each ofthe one or more cables 501 is 0.062 inches. The clamping plates arestacked next to each other, with a cable segment or cable 501 in eachgroove, nestled partway into the groove in a plate on one side, and inthe groove of another plate on the other side. The parallel pair ofgrooves 1204A-1204B in the clamping plates respectively align uptogether with the parallel pair of grooves 1204B-1204A of anotherclamping plate forming the openings 1204 in the clamping block 1012 toclamp around the cable or cable segments.

The outer clamping plate 1214A further includes a threaded opening 1220to receive the threads of the clamping screw 1208A and a through opening1221 to allow the clamping screw 1208B to pass through it into the otherclamping plates. The outer clamping plate 1214B further includes athreaded opening 1220 to receive the threads of the clamping screw 1208Band a through opening 1221 to allow the clamping screw 1208A to passthrough it into the other clamping plates. Thus, the outer clampingplates 1214A-1214B may be substantially similar to reduce cost. In thismanner, the clamping screws 1208A-1208B squeeze all clamping platestogether from opposite sides to conserver space and assemble theclamping block 1012 together. The screw clamping force is not divided upbetween the joints of the clamping plates, but rather is applied to all.Thus, the clamping screws 1208A-1208B may be small screws and can stillclamp with a substantial clamping force around the cables.

In one embodiment of the invention, with five clamping plates and fourjoints between them each having a pair of grooves between them, eightcables or eight cable segments of four cables may be received. Withadditional clamping plates more cables or cable segments may bereceived. Alternatively, additional grooves may be provided in each toincrease the number of cables or cable segments clamped by the clampingblock 1012. Alternatively, fewer grooves may be provided in each toincrease the clamping force. In one embodiment of the invention, theclamping plates may only have one groove instead of a pair of groovesper side to provide twice the clamping force. To clamp around eightcables or eight cable segments of four cables, nine clamping plates areprovided, two outer clamping plates 1214A-1214B and seven interiorclamping plates.

As previously mentioned, the two ribbonizer halves 1015A-1015B include aslot 1212A-1212B respectively so that the ribbonizer 1015 may receivethe clamping block 1012. The threaded sleeve 612 also includes a pair ofslots 1213 on opposite sides to receive a portion of the clamping block1012 and hold it in place. The clamping block 1012 is in turn fittedinto the opening 1120 in the anti-rotation plate 1008 to keep theclamping block 1012, the threaded sleeve 612, and the ribbonizer 1015from rotating in the cavity 611 of the housing 601.

An end of the ribbonizer 1015 is bolted to the anti-rotation plate 1008.At least one pair of fasteners 1122 are inserted through at least onepair of diagonally spaced apart holes 1121 in the anti-rotation plate1008. The pair of fasteners 1122 are threaded into at least one pair ofthreaded holes 1241 to couple the ribbonizer to the anti-rotation plate.

The threaded sleeve 612 has an external thread 1013 to threadinglyengage an inner thread 1056 of the nut 1006. The tension adjustment inthe one or more cables 501 is provided by rotating the nut 1006 onto thethreaded sleeve 612 to compress the compressible spring 515. Theinternal threads 1056 of the nut 1006 match the outer threads 1013 ofthe threaded sleeve 612.

Each end of the one or more cables 501 has a cable terminator 1303crimped near its end and a spring 1302. The spring 1302 is trappedbetween the cable terminator 1303 and the end of the clamping block1012. If there were no springs 1302, it would be difficult to make thetensions the same in the one or more cables 501, because the cables arenot manufactured exactly the same length, and they may stretch varyingamounts during initial assembly. During assembly, the clamping plates ofthe clamping block 1012 are initially left loose. The compression on thecompression spring 515 and the tension in the one or more cables ispartially adjusted for the expected weight. The spring assembly 602including the clamping mechanism 615 is run back and forth in thehousing 601 by pivoting the link 292 to take out the initial stretch. Atthis point, all the tension on each cable is being applied to thesprings 1302. Due to the variations previously mentioned above, some ofthe springs 1302 may be compressed more than others. The difference intension between the one or more cables 501 or their segments is thedifference in length times the spring rate of the springs 1302. Forexample, if the difference in length between a pair of segments orcables is 0.06 inches and the spring rate is 52 pounds/inch, thedifference in tension is 3 pounds (lb). The difference in tension inother cables or cable segments may be within a range of ten pounds, suchas 8 lb or 5 lb for example.

After the one or more cables are pre-tensioned, the clamp screws1208A-1208B are tightened to clamp the one or more clamping plates ofthe clamping block around the one or more cables 501. Then the compactcounter balancing mechanism can be adjusted for proper balance bycompression adjustment in the compression spring and adjusting thedimensions of the triangle formed by the center points of the pulleys.Prior to further adjustment, the total load in the spring 515 is about500 lb, and if eight cable segments are used, about 500/8 or 62lb percable segment. As long as each of the one or more cables 501 have thesame characteristics, the difference in tension between the cablesegments or cables remains. For example, some of the segments or cableswill have a tension of 60 lb while other will have a tension of 63 lb.The percentage variation in tension is relatively small, and each of thecable segments or cables share the load well. Another function of thesprings 1302 and cable terminators 1303 of the cable end tensioners 616is that if the clamp plates of the clamping block 1012 were to slip, thecables 501 could only slide a little bit until the springs 1302 went totheir solid height. The cable terminators 1303 of the cable endtensioners 616 are crimped sufficiently to the ends of the one or morecables so they will not give with the maximum load being applied to thespring 515.

The preload balance adjustment nut 1006 extends along a portion of thethreaded sleeve 612 and includes an internal thread 1016 to threadinglyengage the external thread 1013 of the threaded sleeve 612. As the nut1006 is turned in one direction, it pulls out on the threaded sleeve 612and compresses the spring 515 through the mating ring 1002 and thethrust bearing 1002. The arrows 1021-1022 in FIG. 10 illustrate thedirection of movement of the nut 1006 along the sleeve 612 as the nut isturned to generate a larger tension in the spring 515 and the one ormore cables 501. The coaxial threaded sleeve 612 and its cable clamp1012 are moved outward away from the spring 515 to increase the tensionin the spring 515 and the one or more cables 501. The nut 1006 is turnedin an opposite direction so that the threaded sleeve 612 and its cableclamp 1012 move into the spring 515 thereby releasing tension in thespring 515 and the one or more cables 501. In a bottom side of thehousing 601 are one or more openings 1050 into the cavity 611 to gainaccess to and adjust the nut 1006.

Due to friction, the nut 1006 can't be adjusted when the full force ofthe spring 515 is pushing on it. There are pin holes 815 in the eachside of the housing 601 into which spring holding pins may be inserted.To pin the spring 515, the counter balancing mechanism is pulled up ordown until an appropriate pair of pin holes 815 on each side of thehousing line up with the groove 1052 in the mating ring 1002 and put arestraining pin (not shown) in from each side to restrain the spring 515from releasing. Lifting up on the counter balance link 292 relieves thetension force from the cables so that the adjustment nut 1006 can beturned easily. After the adjustment nut 1006 is rotated an appropriateamount, the restraining pins are removed from the groove 1052 and thepin holes 815 so that the spring 515 releases back into a position alongthe cavity 611 to apply a tension in the one or more cables 501.

The mating ring 1002 mates the spring 515 to the clamping mechanism. Themating ring 1002 includes an aligning lip 1032 on one side. The aligninglip 1032, along with the body of the threaded sleeve 612, hold thespring 515 in alignment at one end within the cavity 611 of the housing601. An opposite side of the mating ring 1002 couples to the thrustbearing 1004.

On one side, the thrust bearing 1004 allows the nut 1006 to rotate sothat its threads 1016 can threadingly engage the threads 1013 of thethreaded sleeve 612. The opposite side of the thrust bearing 1004presses down against a side of the mating ring 1002 to compress thespring 515.

Referring now to FIGS. 10 and 11A-11B, the anti-rotation plate 1008 hasone or more protrusions 1118 (see FIG. 11A) that engage recesses (notshown) within the cavity 611 of the housing 601. A rectangular opening1120 in the anti-rotation plate 1008 receives the clamping block 1012.One or more bolts or fasteners 1122 couple the anti-rotation plate 1008to the top of the threaded sleeve 612. The one or more protrusions 1118of the anti-rotation plate 1008 when engaged into the recesses of thecavity in the housing deter the threaded sleeve 612 and the clampingblock 1012 from rotating within the cavity 611 as the pre-tensioning nutis turned. This allows the pre-tensioning nut to adjust the tension andavoids the one or more cables 501 from twisting together. With theprotrusions 1118 in the recesses, the anti-rotation plate 1008 movesalong the wall of the cavity 611 with the threaded sleeve 612 as the nut1006 is turned and as the spring is compressed and released by the oneor more cables 501.

As shown in FIGS. 8-9, the plug 613 may include a split 813 along a topportion to split it into split portions and allow the end cap toslightly compress when inserted into the cavity 611 of the housing 601.As is illustrated in FIG. 10, the plug 613 includes a fastener 1030 nearits top portion having the split 813. The fastener 1030 forces the splitportions of the plug 613 apart to expand the plug 613 against the wallsof the cavity 611. A fastener 1031 is inserted through the housing 601and threaded into a bottom portion of the plug 613. The fastener 1031aligns the plug 613 within the cavity 611. One end of the springs of thecable end tensioners 616 couples to the clamping block 1012. Theopposite end of the springs couple to a cable terminator that is crimpedonto each of the one or more cables.

To couple the cable clamping mechanism to the one or more cables neartheir ends during assembly of the parallel linkage structure 246 and thecounter balancing link 292, the compression spring 515 is pinned into acompressible state by inserting a pair of pins into one of the holes 815on each side of the housing 601 so that the nut 1006 may be turned. Fromthe post 505, the one or more cables 501 are routed over the pulleys502-504 or 502′-504′ and into the cavity 611,611′ and through the spring515. The one or more cables are further slid through the clamping platesof the clamping block 1012. Each of the one or more cables 501 isindependently pre-tensioned by the one or more cable end tensioners 616to remove the slack in the cables and to substantially equalize aninitial tension in each. In one embodiment of the invention, the initialtension in each cable is set by the spring 1302 in the cable endtensioner 616. In one embodiment of the invention, the initial tensionin each cable is on the order of ten pounds.

After pre-tensioning the one or more cables 501, the clamping mechanismis engaged to clamp the one or more cables to the clamping block 1012.The clamping screws are turned to move the clamping plates to capturethe one or more cables against the clamping block 1012.

Next, the one or more cables 501 are tensioned to counter balance anexpected weight or load that is to be supported at the set-up arm. Theload may be the weight of a robotic arm, medical equipment, furtherlinkage or other devices that may couple to the parallelogram linkagestructure. The pre-load adjustment nut 1006 is turned to adjust thetension in the spring 515 and establish a tension in the cables. Thetension in the spring 515 may be substantially equally shared by the oneor more cables 501. The position of block 513 to which the pulley 503 iscoupled may also be adjusted as needed to compensate for springvariations or load variations.

With the counter-balancing link assembled and calibrated in theparallelogram linkage structure, the expected weight or load on the setup arm can be balanced out so that the linkage structure can be readilymoved in a vertical direction against the force of gravity. As thelinkage structure is moved, the moment or force at the joints of thecounter-balancing link may vary. The counter-balancing link 292 balancesout or compensates for the variance or change in moment or force at itsjoints. Generally, the variable force or moment generated by thecounter-balancing link 292 to balance out or compensate for the momentor force at its joints may be referred to as a counter balancing forceor counter balancing moment. The one or more cables 501 wrap or unwrapover the pulleys 502-504 in the counter balancing link 292 to compressor decompress the spring 515 and respectively increase or decrease thetension in the one or more cables 501 in generating the counterbalancing force. An increase in tension in the one or more cables 501balances out an increase in moment or force at the joints of the counterbalancing link 292. A decrease in tension in the one or more cables 501balances out a decrease in moment or force at the joints of the counterbalancing link 292.

After the set-up arm has been moved into proper position and the load orweight balanced out, the set-up joint brakes may be applied to determovement in the set up arm, the parallelogram linkage structure, and thecounter balancing link 292.

Compact Spring Balancing Theory

Referring now to FIG. 14A, a single link 1400 is illustrated pivotallycoupled to a vertical wall 1402 at a pivot point O. The link 1400rotating in a vertical (and horizontal) plane can be balanced by alinear spring 1401 so that it is in equilibrium in any position despitethe effect of gravity. The force of gravity (f=mg) is equal to the massm times the acceleration of gravity g which is exerted at the midpointof the link. The length of the link 1401 is 21 so that its midpoint is adistance l along the link. The linear spring 1401 has a spring constantK and couples to the link 1401 at a point v and the wall 1402 at a pointw. The link 1400 makes an angle theta with the wall W as illustrated inFIG. 14A.

Referring now to FIG. 14B, a schematic diagram of the rigid link 1400 isillustrated pinned at point O and held by the linear spring 1401attached to the vertical wall 1402 at the point w. A distance xseparates points w and v. A distance b separates points w and o. Adistance a separates points o and v. A distance t is along a linebetween point o and a point normal to the line between points w and v.

For the link to be in equilibrium with the force of gravity, the momentM_(o) about the point O should be substantially zero. From FIG. 14B wecan determine the equation for the moment M_(o) about the point O as:M _(o) =mgl sin θ−K(x−x _(o))t=0

where x₀ is the unstretched length of the spring.

Rearranging the terms of the equation we havemgl sin θ=K(x−x _(o))t

With the link 1400 at an angle theta (θ) with the wall that is not equalto zero, we can substitute in an equation for t derived from similartriangles (see FIG. 15B):t/b=a sin θ/x

Rearranging the equation to solve for t we find:t=ab sin θ/x

Substituting in the equation for t which cancels the sine terms we find:mgl=K(x−x _(o))ab/x

If the unstretched length of the spring, x₀, is equal to zero, theequation further reduces to:mgl=Kab

Rearranging the terms to solve for the spring constant, we have:K=mgl/ab

Thus, the equation for the spring constant K indicates that thestiffness K of the spring 1401 can be constant and independent of theangle theta θ of the link. The stiffness K of the spring can be constantand independent of the angle theta θ if the unstretched length x₀ of thespring 1401 is chosen to be substantially zero. The unstretched lengthx₀ of the spring 1401 may be set to substantially zero if the tensionspring 1401 is placed outside the line connecting the points w and v.

Therefore, the link 1400 may be balanced for all of its positions if (i)the stiffness K of the spring is properly chosen according to theequation K=mgl/ab; and (ii) the spring is placed outside of the line wvbetween its connection to the link and a fixed reference point.

Referring now to FIG. 15A, a spring, pulley, and cable counter balancingmechanism for the link 1400 is illustrated. FIG. 15A illustrates atension spring 1501 placed outside the line connecting points w and v sothat the unstretched length x₀ of the spring 1501 is effectively set tosubstantially zero. A cable 1503 is routed from the spring 1501 over apulley 1502 at the point v and coupled to the wall 1402 at the point w.For accurate balance, the diameter of the pulley 1502 should be smallrelative to the sides a and b of the triangle. However where springloads are high, a cable that is strong enough to hold a load safelyneeds a pulley of an appropriate size so as not to fail from bendingfatigue during use. Thus, the single pulley 1502 may not be practicalfor some applications. In which case, a three pulley system may be usedas illustrated in FIG. 15C.

FIG. 15B illustrates a schematic diagram of the rigid link 1400 with asimilar triangle to that of FIG. 14A. FIG. 15C illustrates a schematicdiagram of a three pulley system corresponding to the schematic diagramof FIG. 15B. As described previously, the distance x separates points wand v. The distance b separates points w and o. The distance a separatespoints o and v. The distance t is along a line between point o and apoint normal to the line between points w and v.

In FIG. 15C, a schematic diagram of a spring-cable-pulley balancingmechanism is illustrated with three pulleys 1512A-1512C for balancingthe weight and moment of the link 1400. A cable 1513 is wrapped around aportion of each of the three pulleys 1512A-1512C. Each of the threepulleys 1512A-1512 may be of equal diameter, and the distances a and bin the system can be maintained constant. However as the angle theta θchanges, the total cable path length (a+b+x) of the cable 1513 changesby the same amount as x does, because the total wrap angle of the cable1513 on the three pulleys is constant. The change in cable length pullsor pushes on the spring of the spring assembly 602 and adjusts thecounter balance force applied to maintain a substantially zero momentand balance out the weight of the link.

The additional weight of additional links and an attached roboticsurgical arm may also be balanced out by a counter balancing force withan appropriate choice of spring constant K and cabling that is capableof withstanding the additional forces applied.

CONCLUSION

While a parallelogram link structure 246 of the set-up joint arm 140 hasbeen described in detail with reference to the patient side manipulator(PSM) 132, a parallelogram linkage structure may be also used in theset-up joint center arm 138 supporting the endoscope camera roboticmanipulator 134 or other set-up joint arms or structures of a roboticsurgical system.

As illustrated in FIG. 1, the set-up joint center arm 138 comprises arelatively short, near vertical rigid arm defined primarily by theparallelogram link structure 246. The set-up joint center arm 138 has ashorter parallelogram link 252 than the other three arms 140, 142, 144.The set-up joint center arm 138 has three degrees of freedom that aretypically manually positioned. The set-up joint center arm 138 is freeof any redundant joints as the azimuth angle is controlled by therotation of the orienting platform 136. The set-up joint center arm 138may be vertically translated similar as denoted by arrow SJC3. Thegeneral rotational motion of the set-up joint center arm 138 is denotedby arrow SJC4 in FIG. 1.

While embodiments of the invention have been described in detail withreference to a ceiling mounted robotic surgical system 100, theembodiments of the invention may be equally applicable to roboticsurgical systems that do not mount to the ceiling but instead aresupported by flooring or mounted to a table. Additionally, theembodiments of the invention have been described in detail withreference to a parallelogram linkage structure. However, the embodimentsof the invention may be equally applicable to other linkages, such asserial linkage arm structures that are to be counter balanced or otherparallel linkage structures that are to be counter balanced. Moreover,the embodiments of the invention have been described with reference to aspring-cable-pulley counter-balancing mechanism. The cable and pulleysmay instead be a belt or strap and pulleys, a chain and sprockets, aperforated metal tape and pulleys with bull nose pins, or a timing beltand timing gears. The pulleys, sprockets, pulleys with bull nose pinsand timing gears may be collectively referred to as rotatingtransmission devices. The cable, belt, strap, chain, perforated metaltape, and timing belt may be collectively referred to as a tensionmechanism.

Although certain exemplary embodiments and methods have been describedin some detail, for clarity of understanding and by way of example, itwill be apparent from the foregoing disclosure to those skilled in theart that variations, modifications, changes, and adaptations of suchembodiments and methods may be made without departing from the truespirit and scope of the invention. Therefore, the above descriptionshould not be taken as limiting the scope of the invention which isdefined by the appended claims.

1. A set-up arm to support a robotic arm, the set-up arm comprising: afirst set-up joint to couple to a support structure; a second set-upjoint spaced apart from the first set-up joint, the second set-up jointto couple to a robotic arm to provide support thereto; a counterbalancing link pivotally coupled to the first set-up joint at a firstpivot point and to the second set-up joint at a second pivot point, thecounter balancing link to balance out the force of load at the secondset-up joint, the counter balancing link including a hollow housinghaving a cylindrical cavity with a first opening at a first end; aspring in the cylindrical cavity having a first end coupled to thehollow housing, the spring to provide a spring force to balance out theforce of load at the second set-up joint; a plurality of pulleysincluding a first pulley rotatably coupled to the first set-up joint atthe first pivot point between the counter balancing link and the firstset-up joint, and one of a pair of pulleys rotatably coupled to thefirst setup joint and another one of the pair of pulleys rotatablycoupled to the hollow housing; at least one cable under tension coupledto the setup arm and wrapped over the plurality of pulleys to couple toa second end of the spring; and wherein a linear distance between thepair of pulleys varies to change a cable path length in response to thepivoting of the counter balancing link with respect to the first set-upjoint to modify the spring force and the tension in the at least onecable under tension to counter balance changes in moment and mechanicaladvantage.
 2. A set-up arm to support a robotic arm, the set-up armcomprising: a first set-up joint to couple to a support structure, thefirst set-up joint having a first pulley rotatably coupled thereto; asecond set-up joint spaced apart from the first set-up joint, the secondset-up joint to couple to a robotic arm to provide support thereto; acounter balancing link pivotally coupled to the first set-up joint at afirst pivot point and to the second set-up joint at a second pivotpoint, the counter balancing link to balance out the force of load atthe second set-up joint, the counter balancing link including a hollowhousing having a cylindrical cavity with a first opening at a first enda second pulley rotatably coupled to the hollow housing, a firstcompression spring in the cylindrical cavity having a first end coupledto the housing, the first compression spring under compression tobalance out the force of load at the second set-up joint; and a thirdpulley having a center point at the first pivot point between thecounter balancing link and the first set-up joint, wherein center pointpositions of the first, second, and third pulleys are corners of atriangle, wherein the triangle formed by the center point positions ofthe first, second and third pulleys is adjustable in response topivoting of the counter balancing link with respect to the first set-upjoint to modify the tension in the at least one cable under tension; atleast one cable under tension wrapped over the second pulley into thecylindrical cavity and coupled to a second end of the first compressionspring, the at least one cable under tension further wrapped over thefirst and third pulleys and coupled to the set-up arm; and wherein a sumof the wrap angles of the at least one cable under tension wrappedaround the first, second and third pulleys is substantially constant inresponse to the pivoting of the counter balancing link with respect tothe first set-up joint; and a linear distance between the first pulleyand the second pulley varies in response to the pivoting of the counterbalancing link with respect to the first set-up joint to modify thetension in the at least one cable under tension to balance out changesin moment and mechanical advantage at the pivot point between thecounter balancing link and the first set-up joint due to the pivoting ofthe counter balancing link and the load at the second set-up joint. 3.The set-up arm of claim 1, wherein the at least one cable under tensionis coupled to the set up arm by coupling to the counter balancing link,the first set-up joint, or the second set-up joint.
 4. The set-up arm ofclaim 1, wherein the at least one cable under tension is coupled to theset up arm by wrapping over a post coupled to the counter balancinglink, the at least one cable under tension is twice wrapped over theplurality of pulleys, and the at least one cable under tension has apair of ends coupled to the second end of the first compression spring.5. The set-up arm of claim 1, wherein the at least one cable undertension is a plurality of cables under tension each of which has asubstantially similar tension to share the total tension generated bythe compression of the first compression spring.
 6. The set-up arm ofclaim 1, wherein the hollow housing has a first diagonally cut end and asecond diagonally cut end opposite the first diagonally cut end, thefirst diagonally cut end and the second diagonally cut end to increasemovement of the counter balancing link about the first set-up joint andthe second set-up joint, respectively.
 7. The set-up arm of claim 1,wherein each of the plurality of pulleys has a substantially similardiameter.
 8. A set-up arm to support a robotic arm, the set-up armcomprising: a first set-up joint to couple to a support structure, thefirst set-up joint having a first pulley rotatably coupled thereto; asecond set-up joint spaced apart from the first set-up joint, the secondset-up joint to couple to a robotic arm to provide support thereto; acounter balancing link pivotally coupled to the first set-up joint at afirst pivot point and to the second set-up joint at a second pivotpoint, the counter balancing link to balance out the force of load atthe second set-up joint, the counter balancing link including a hollowhousing having a cylindrical cavity with a first opening at a first end,a second pulley rotatably coupled to the hollow housing, a firstcompression spring in the cylindrical cavity having a first end coupledto the housing, the first compression spring under compression tobalance out the force of load at the second set-up joint; and a thirdpulley having a center point at the first pivot point between thecounter balancing link and the first set-up joint, wherein center pointpositions of the first, second, and third pulleys are corners of atriangle; at least one cable under tension wrapped over the secondpulley into the cylindrical cavity and coupled to a second end of thefirst compression spring, the at least one cable under tension furtherwrapped over the first and third pulleys and coupled to the set-up arm;and wherein each of the first, second, and third pulleys have asubstantially similar diameter, a first linear distance between thefirst pulley and the second pulley to vary in response to a pivoting ofthe counter balancing link at the first pivot point with the firstset-up joint; a second linear distance between the first pulley and thethird pulley to remain constant in response to the pivoting of thecounter balancing link at the first pivot point with the first set-upjoint; and a third linear distance between the second pulley and thethird pulley to remain constant in response to the pivoting of thecounter balancing link at the first pivot point with the first set-upjoint.
 9. A set-up arm to support a robotic arm, the set-up armcomprising: a first set-up joint to couple to a support structure, thefirst set-up joint having a first pulley rotatably coupled thereto; asecond set-up joint spaced apart from the first set-up joint, the secondset-up joint to couple to a robotic arm to provide support thereto; acounter balancing link pivotally coupled to the first set-up joint at afirst pivot point and to the second set-up joint at a second pivotpoint, the counter balancing link to balance out the force of load atthe second set-up joint, the counter balancing link including a hollowhousing having a cylindrical cavity with a first opening at a first enda plug coupled into the first opening to close the cylindrical cavity atthe first end to increase stiffness of the counter balancing link, asecond pulley rotatable coupled to the hollow housing, a firstcompression spring in the cylindrical cavity having a first end coupledto the housing, the first compression spring under compression tobalance out the force of load at the second set-up joint; and a thirdpulley having a center point at the first pivot point between thecounter balancing link and the first set-up joint, wherein center pointpositions of the first, second, and third pulleys are corners of atriangle; and at least one cable under tension wrapped over the secondpulley into the cylindrical cavity and coupled to a second end of thefirst compression spring, the at least one cable under tension furtherwrapped over the first and third pulleys and coupled to the set-up arm.10. The set-up arm of claim 9, further comprising: an idle linkpivotally coupled to the first set-up joint at a third pivot point andto the second set-up joint at a fourth pivot point substantiallyparallel to the counter balancing link, the idle link to increase thestiffness in the set-up arm between the first set-up joint and thesecond set-up joint and the load carrying capability of the set-up arm.11. The set-up arm of claim 10, wherein the first set-up joint has afirst bracket coupled to the idle and counter balancing links at thefirst and third pivot points respectively, the first bracket to allowthe first set-up joint to rotate about a first axis; and the secondset-up joint has a second bracket coupled to the idle and counterbalancing links at the second and fourth pivot points respectively, thesecond bracket to allow the second set-up joint to rotate about a secondaxis.
 12. The set-up arm of claim 10, wherein the idle link and thecounter balancing link are a parallel link, and the first and thirdpivot points and the second and fourth pivot points spaced apart by thehousing of the idle link and the housing of the counter balancing linkto increase the torsional stiffness of the parallel link.
 13. The set-uparm of claim 12, wherein the counter balancing link further includes aclamping mechanism to couple the at least one cable under tension to thesecond end of the first compression spring.
 14. The set-up arm of claim13, wherein the clamping mechanism includes a ribbonizer in a centeropening of the first compression spring and coaxial thereto, theribbonizer having a pair of slots at one end, and a clamping blockcoupled into the pair of slots of the ribbonizer, the clamping block tocouple the at least one cable under tension to the first compressionspring.
 15. The set-up arm of claim 14, wherein the clamping mechanismfurther includes a threaded sleeve around the ribbonizer coaxial withthe compression spring, the threaded sleeve having an external thread,an end of the threaded sleeve coupled to a ridge of the ribbonizer, anut having an internal thread threadingly engaged to the external threadof the threaded sleeve, the pre-tensioning nut to adjust the tension inthe at least one cable under tension, and a mating ring over thethreaded sleeve, the mating ring to receive a force from the nut andcouple it to the first compression spring to adjust the tension in theat least one cable under tension.
 16. The set-up arm of claim 15,wherein the clamping mechanism further includes a thrust bearing overthe threaded sleeve and coupled between the nut and the mating ring, thethrust bearing to receive a force from the nut and couple it to themating ring.
 17. The set-up arm of claim 16, wherein the clampingmechanism further includes an anti-rotation plate having an opening overthe clamping block and coupled to the ribbonizer, the anti-rotationplate having one or more protrusions coupled into one or more recessesin the cavity to deter the ribbonizer, the threaded sleeve and theclamping block from rotating as the nut is turned.
 18. The set-up arm ofclaim 14, wherein the clamping mechanism further includes one or morecable tensioners coupled between at least one end of the at least onecable under tension and the clamping block, the one or more cabletensioners to pre-tension the at least one cable under tension, each ofthe one or more cable tensioners including a second compression springover the at least one cable under tension, and a cable terminatorcoupled to the at least one cable under tension near an end thereof. 19.The set-up arm of claim 14, wherein the at least one cable under tensionis a plurality of cables under tension, and the clamping block includesa plurality of clamping plates stacked together, each of the pluralityof clamping plates having a first opening, a second opening spaced apartfrom the first opening, and at least one groove to capture at least onecable segment of the plurality of cables under tension; a first fastenerinserted into the first opening in each of the plurality of clampingplates; and a second fastener inserted into the second opening in eachof the plurality of clamping plates; and wherein the first fastener andthe second fastener squeeze the plurality of clamping plates togetheraround the cable segments to clamp thereon with a substantial force. 20.The set-up arm of claim 19, wherein the plurality of clamping platesincludes a first outer clamping plate having the at least one groove ina top side; one or more interior clamping plates over the first outerclamping plate, each of the one or more interior clamping plates havingat least one first groove in a top side and at least one second groovein a bottom side, one interior clamping plate having its at least onesecond groove aligned over the at least one groove in the first outerclamping plate; and a second outer clamping plate having the at leastone groove in a bottom side, the at least one groove in the second outerclamping plate aligned over the at least one first groove in oneinterior clamping plate.
 21. The set-up arm of claim 20, wherein theplurality of cables have a substantially similar diameter, and a depthof each of the at least one groove in the plurality of clamping platesis less than half the diameter of the plurality of cables.
 22. Theset-up arm of claim 20, wherein the first and second openings in thefirst outer clamping plate are threaded to threadingly couple to thefirst and second fasteners respectively to squeeze the plurality ofclamping plates together around the cable segments to clamp thereon witha substantial force.
 23. The set-up arm of claim 20, wherein the firstopening in the first outer clamping plate is threaded to threadinglycouple to the first fastener, the second opening in the second outerclamping plate is threaded to threadingly couple to the second fastener,and wherein the first fastener and the second fastener from oppositesides squeeze the plurality of clamping plates together around the cablesegments to clamp thereon with a substantial force.
 24. The set-up armof claim 19, wherein the plurality of cables under tension are routedsubstantially in parallel together, and the at least one groove in eachof the plurality of clamping plates is a pair of grooves substantiallyin parallel to capture cable segments of the plurality of cables undertension.
 25. The set-up arm of claim 1, wherein a first wrap angle ofthe at least one cable under tension around the first pulley to decreaseto pay out cable and slightly compensate for an increase in the lineardistance between the pair of pulleys in response to a first pivoting ofthe counter balancing link with respect to the first set-up joint; andthe first wrap angle to increase to pull in cable and slightlycompensate for a decrease in the linear distance between the pair ofpulleys in response to a second pivoting of the counter balancing linkwith respect to the first set-up joint in a direction opposite that ofthe first pivoting.
 26. The set-up arm of claim 1, wherein a total cablelength of the at least one cable under tension is constant while thecable path length varies to modify the spring force and the tension inthe at least one cable under tension in response to the pivoting of thecounter balancing link with respect to the first set-up joint.
 27. Theset-up arm of claim 26, wherein a sum total of wrap angles of the atleast one cable under tension around the plurality of pulleys isconserved to remain constant in response to the pivoting of the counterbalancing link with respect to the first set-up joint.
 28. The set-uparm of claim 1, further comprising: an idle link pivotally coupled tothe first set-up joint at a third pivot point and to the second set-upjoint at a fourth pivot point parallel to the counter balancing link.29. The set-up arm of claim 2, further comprising: an idle linkpivotally coupled to the first set-up joint at a third pivot point andto the second set-up joint at a fourth pivot point parallel to thecounter balancing link.
 30. The set-up arm of claim 6, furthercomprising: an idle link pivotally coupled to the first set-up joint ata third pivot point and to the second set-up joint at a fourth pivotpoint parallel to the counter balancing link.
 31. The set-up arm ofclaim 6, wherein the at least one cable under tension is further coupledto the set up arm.
 32. The set-up arm of claim 6, wherein the at leastone cable under tension is a plurality of cables under tension each ofwhich has a substantially similar tension to share the total tensiongenerated therein by the spring.
 33. The set-up arm of claim 8, furthercomprising: an idle link pivotally coupled to the first set-up joint ata third pivot point and to the second set-up joint at a fourth pivotpoint parallel to the counter balancing link.